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  <h2>贵宾问卷</h2>
</header>
<section class="section-pb">
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    <h2>
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    </h2>
    <div class="content show" >
      <div class="join vest">
  
        <form action="__URL__/fillvest" method="post">
          <div class="form-group cc">
            <label>姓名:</label>
            <div class="control">
              <input type="text" name='name' class="form-control"  placeholder="请填写您的姓名">
            </div>
          </div>

          <div class="form-group cc">
            <label>性别:</label>
            <div class="control">
              <span class="radio"><input type="radio" value='男' name="sex"> 男</span>
              <span class="radio"><input type="radio" value="女" name="sex"> 女</span>
            </div>
          </div>

          <div class="form-group cc">
            <label>年龄:</label>
            <div class="control">
              <input type="text" name="age" class="form-control"  placeholder="请填写您的年龄">
            </div>
          </div>

          <div class="form-group cc">
            <label>名下房产:</label>
            <div class="control">
              <span class="radio"><input type="radio" value='1套' name="have_house"> 1套 </span>
              <span class="radio"><input type="radio" value='2套' name="have_house"> 2套 </span>
              <span class="radio"><input type="radio" value='3套' name="have_house"> 3套 </span>
              <span class="radio"><input type="radio" value='4套' name="have_house"> 4套 </span>
            </div>
          </div>

          <div class="form-group cc">
            <label>联系电话:</label>
            <div class="control">
              <input type="text" name='phone' class="form-control"  placeholder="请填写联系电话">
            </div>
          </div>

          <div class="form-group cc">
            <label>现居住区域:</label>
            <div class="control">
              <span class="radio"><input type="radio" value='南湖区' name="now_live"> 南湖区</span>
              <span class="radio"><input type="radio" value='秀洲区' name="now_live"> 秀洲区</span>
              <span class="radio"><input type="radio" value='国际商务区' name="now_live"> 国际商务区</span>
              <span class="radio"><input type="radio" value='其他' name="now_live"> 其他</span>
            </div>
          </div>

          <div class="form-group cc">
            <label>购房目的:</label>
            <div class="control">
              <span class="radio"><input type="radio" value='成家' name="purpose"> 成家</span>
              <span class="radio"><input type="radio" value='为子女购房' name="purpose"> 为子女购房</span>
              <span class="radio"><input type="radio" value='改善条件' name="purpose"> 改善条件</span>
              <span class="radio"><input type="radio" value='父母一起住' name="purpose"> 父母一起住</span>
              <span class="radio"><input type="radio" value='投资兼自住' name="purpose"> 投资兼自住</span>
            </div>
          </div>

          <div class="form-line"></div>

          <div class="form-group cc">
            <label>需求类型:</label>
            <div class="control">
              <span class="radio"><input type="radio" value='洋房' name="need_type"> 洋房</span>
              <span class="radio"><input type="radio" value='高层' name="need_type"> 高层</span>
              <span class="radio"><input type="radio" value='小高层' name="need_type"> 小高层</span>
            </div>
          </div>
          <div class="form-group cc">
            <label>户型:</label>
            <div class="control">
              <span class="radio f11"><input type="radio" value="二房二厅一卫" name="door_model"> 二房二厅一卫</span>
              <span class="radio f11"><input type="radio" value="三房二厅一卫" name="door_model"> 三房二厅一卫</span>
              <span class="radio f11"><input type="radio" value="三房二厅二卫" name="door_model"> 三房二厅二卫</span>
              <span class="radio f11"><input type="radio" value="四房二厅二卫" name="door_model"> 四房二厅二卫</span>
            </div>
          </div>

          <div class="form-group cc">
            <label>面积:</label>
            <div class="control">
              <span class="radio"><input type="radio" value='80-90㎡' name="area"> 80-90㎡</span>
              <span class="radio"><input type="radio" value='110-120㎡' name="area"> 110-120㎡</span>
              <span class="radio"><input type="radio" value='130-140㎡' name="area"> 130-140㎡</span>
              <span class="radio"><input type="radio" value='170㎡' name="area"> 170㎡</span>
            </div>
          </div>

          <div class="form-group cc">
            <label>总价:</label>
            <div class="control">
              <span class="radio"><input type="radio" value='60-70万' name="total_price"> 60-70万</span>
              <span class="radio"><input type="radio" value='70-80万' name="total_price"> 70-80万</span>
              <span class="radio"><input type="radio" value='80-90万' name="total_price"> 80-90万</span>
              <span class="radio"><input type="radio" value='90-100万' name="total_price"> 90-100万</span>
              <span class="radio"><input type="radio" value='100万以上' name="total_price"> 100万以上</span>
            </div>
          </div>

          <div class="form-group cc">
            <label>楼层/多层:</label>
            <div class="control">
              <span class="radio"><input type="radio" value='1-2层' name="floor_duo"> 1-2层</span>
              <span class="radio"><input type="radio" value='3-4层' name="floor_duo"> 3-4层</span>
              <span class="radio"><input type="radio" value='5-7层' name="floor_duo"> 5-7层</span>
            </div>
          </div>
          <div class="form-group cc">
            <label>楼层/高层:</label>
            <div class="control">
              <span class="radio"><input type="radio" value='1-5层' name="floor_gao"> 1-5层</span>
              <span class="radio"><input type="radio" value='6-10层' name="floor_gao"> 6-10层</span>
              <span class="radio"><input type="radio" value='11-12层' name="floor_gao"> 11-12层</span>
              <span class="radio"><input type="radio" value='13-18层' name="floor_gao"> 13-18层</span>
            </div>
          </div>

          <div class="form-line"></diiv>
          <div class="form-group-v2">
            <label>选择住宅的最关注因素：（排序选择、至少三项）</label>
            <div class="control-v2">
              <ul>
                <li><input type="checkbox" value='开发商品牌' > 开发商品牌</li>
                <li><input type="checkbox" value='物业管理'> 物业管理</li>
                <li><input type="checkbox" value='地段'> 地段</li>
                <li><input type="checkbox" value='交通'> 交通</li>
                <li><input type="checkbox" value='教育配套'> 教育配套</li>
                <li><input type="checkbox" value='周边配套'> 周边配套</li>
                <li><input type="checkbox" value='小区规划'> 小区规划</li>
                <li><input type="checkbox" value='小区内配套'> 小区内配套</li>
                <li><input type="checkbox" value='建筑风格'> 建筑风格</li>
                <li><input type="checkbox" value='园林景观'> 园林景观</li>
                <li><input type="checkbox" value='装修标准'> 装修标准</li>
                <li><input type="checkbox" value='户型面积'> 户型面积</li>
                <li><input type="checkbox" value='得房率'> 得房率</li>
                <li><input type="checkbox" value='楼层/位置'> 楼层/位置</li>
                <li><input type="checkbox" value='价格'> 价格</li>
                <li><input type="checkbox" value='付款方式'> 付款方式</li>
              </ul>
            </div>
            <input type="hidden" id='focus' name='focus' >
          </div>
          <div class="form-line"></diiv>
          <div class="form-group cc">
            <div class="control control-v2">
              <button type="submit" class="btn btn-default">确 定</button>
            </div>
          </div>

        </form>
      </div>
    </div>
  </div>
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